Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey

M Pérez-Ríos,B Alonso,Mi Santiago-Pérez,J De Leon,A Malvar,X Hervada

doi:10.1186/1471-2458-9-493

Abstract

BackgroundThe Fagerström Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence. A shorter test derived from the FTND used for the general population is the Heavy Smoking Index (HSI) (six questions vs. two). The objective of this study is to compare the validity of the HSI versus the FTND.MethodsA survey of tobacco use in the general population was carried out in the northern Spanish region of Galicia using both the FTND and the HSI to study a representative sample of 1655 daily smokers. The HSI was compared with the FTND, considered the gold standard. Measures of sensitivity, specificity and predictive values were calculated. Concordance between the tests was also established (Cohen's kappa).ResultsCohen's kappa showed good agreement between measures (Kappa = 0.7); specificity values were also high (Sp = 96.2%). Sensitivity analysis in females (Se = 62.3%) did not show good agreement.ConclusionsThe HSI can be used as a reasonably good screening test in order to identify daily smokers with high nicotine dependence. Nevertheless, for populations or subpopulations having low nicotine dependence, such as women, the FTND is more reliable.

Highlights

The Fagerström Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence
The main goal of the present study was to estimate the agreement between the Heavy Smoking Index (HSI) compared with the FTND in a representative population sample with special attention to gender differences
High dependence was defined as a FTND score ≥ 6 [3,4,5,6,7,8,9,10,11] and a HSI score ≥ 4 [5,8,12]

Summary

Introduction

The Fagerström Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence. A shorter test derived from the FTND used for the general population is the Heavy Smoking Index (HSI) (six questions vs two). The objective of this study is to compare the validity of the HSI versus the FTND. Cross-sectional studies, especially those focused on tobacco use, generally employ long and overloaded questionnaires. The assessment of nicotine dependence is one of the main objectives addressed in tobacco studies. The availability of brief and reliable self-reported measures of addiction for epidemiological studies would be highly desirable. Several instruments have been developed to assess nicotine tobacco dependence. One of them is the Fagerström Test for Nicotine Dependence (FTND), a non invasive and easy-to-obtain self report tool that conceptualizes dependence through physiological and behavioral symptoms. The current version includes six items [1] and though the test is brief, its completion requires a few (page number not for citation purposes)

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